Urinary incontinence

• What are the different types of urinary incontience?

  Stress

  Urge

  Mixed

  Overflow

  Function
• How many types of urinary incontinence is there?


  5
• What are some signs and symptoms of urinary incontinence?


  Frequent urination

  Urinating during sleep

  Sudden, uncontrollable urge to urinate

  Waking many times to urinate

  Leaking urine when laughing/exercising
• What are some risk factors for urinary incontinence?


  Age

  FHx

  High BMI

  Hysterectomy

  Previous pregnancy/birth
• What are some bedside investigations for urinary incontinence?


  Bladder diaries

  Vaginal exam

  Urine dip and culture

  Urodynamic studies
• How can stress urinary incontinence be managed conservatively?


  Pelvic floor muscle training - 8 contractions, 3x per day for 3 months
• How is urge urinary incontinence managed conservatively?


  Bladder retraining

  Increase intervals between voiding
• How can stress urinary incontinence be managed surgically?


  Procedures e.g. retropubic midurethral tape
• How can stress urinary incontinence be managed pharmacologically?


  Duloxetine (if no surgery) -> enhances contraction of bladder sphyncter
• How can urge incontinence be managed pharmacologically?


  Bladder stabilising drugs (oxybutynin)

  Mirabegron if concerned about anticholinergic side effects
• What causes stress incontinence?

  Increased abdo pressure under stress e.g. laughing
• What causes urge incontinence?


  Involuntary contraction of bladder muscles
• What causes overflow incontinence?


  Blockage of the urethra
• What causes functional incontinence?


  Physical limitations
• What are some examples of what can cause urge incontinence?

  Idiopathic

  Neuro conditions

  Inflammation

  Bladder irritants
• What are some examples of what can cause stress incontinence?

  Urethral hypermobility

  Intrinsic sphincter deficiency
• What are some examples of what can cause overflow incontinence?

  Enlarged prostate

  Diabetes

  Obstructing masses

  Iatrogenic